Goals for the Next 30 Days: Continue to Function at 9-10

When it comes to functioning on a scale of 1-10, I’ve generally rated high.  But, there are days.

Function measures how a person gets daily tasks accomplished like getting out of bed, taking a shower, tackling chores.  General consensus of the treatment staff is that if a person is a 4 or under, they probably need to be admitted to the hospital.  Here’s what I’m doing to keep my Function score high.

1. Attend the After-Care support group for one month.
2. Schedule weekly appointments with my therapist
3. Continue Daily Planning
4. Monitor for symptoms of Lapse and put Step-up Plan in place

The After-Care group is an extension of what we did every day at the hospital.  It’s a combination of checking in and being held accountable.  There’s also a deep and unique understanding between peers.  We know the pain and the faulty thinking.  We know when to challenge someone and when to soothe.  There’s nothing like being with folks who “get it.”  But since this group is an hour away, I only committed to attending for four weeks.  Gas money only stretches so far, and I won’t dig myself into debt that way again.  I’m hoping for other options by the time July rolls around.

Weekly sessions with Megan, my therapist, is a no-brainer.  She goes on maternity leave soon, but carefully matched her cases to other therapists in the clinic to minimize our trauma.  I’m constantly amazed by her level of professionalism and the great respect she affords us.  I’ll miss her, but that won’t stop me from utilizing her sub.

In treatment, we made planning an art form.  Self-monitoring, setting small goals, and marking successes kept us moving forward.  It’s easy to lose track of what’s important.  I took the sheet we filled out every day, customized it for my needs, then took it to my copy shop where they made a tear-off pad that I can carry in my writing bag.  In the morning, I rip off a page, quickly fill it out, and tape it in my journal.  This way I can see my progress and where I need to concentrate my efforts.  By keeping my daily plan, I was able to recognize the depression sooner when it came back this week and watch to see if it would turn into a lapse.  With that criteria on my daily plan, I didn’t need to guess or stew about it.  And if I lapsed, I had my Step-up plan taped to my Mind Palace, ready to be put in place.  This time the mood shifted and I didn’t need the extra measures.  It was good practice, because I will need them sometimes.

Even for a planner like me, this new level of self-monitoring feels gnat’s ass-obsessive sometimes.  But, I can see how much it helps.  I can feel it.  And that’s all that matters.

Adding to to the Bad-Ass Arsenal

Today is the end of the four-day week for those of us in treatment.  That means there’s a long, four-day weekend ahead of us with Memorial Day tagged on the end of it.  To get from this side of the holiday weekend to the other requires planning, setting goals for each day, getting out of the apartment, spending time with friends, tending to chores.  A structured mind is a tidy mind.

A couple of Ah-Ha moments this week.  My regular therapist, Megan, and I have been working on Mindfulness practices for several months, but one of the homework modules from treatment put that work in a different light.  It talked about developing a stronger tolerance to emotional distress.  We can’t stop the feelings and moods, but we can become more tolerant of them with practice.  Mindfulness is a way to do that.  The teaching material called it “doing the opposite” of what we habitually do in times of distress.  Most people try to escape the emotional pain, numb it, distract oneself from it.  The opposite of that knee-jerk reaction is to accept the current distress.  Sit with it.  Use meditation, journaling and other methods to pay attention to it and watch how it might shift.

The homework assignments my counselor in treatment have given me come from the Centre for Clinical Intervention, a wonderful Australian website where workbook-type modules on all areas of mental health are available for free.   What a wonderful service!  Those Aussies have the right idea.

The other Ah-Ha moment came with a suggestion in group.  I’ve always maintained a one-size-fits-all management plan for my illness, but it was put to me that I need a different plan when I’m suffering a lapse.  A lapse is when symptoms reappear, but haven’t dragged a person into a long bout that effects functioning in the world.  As someone with the rapid cycling form of bipolar disorder,  I considered myself symptomatic most of the time.  But, I can see now that there are symptoms and there are SYMPTOMS.  There are signs when my “normal” cycling shifts to a lapse—depression that lasts longer than three days, change in sleep quality, etc.  Like an early warning tornado siren, I can watch for the signs of a lapse and put my Emergency Step-Up Plan in place.  It gives me more power.  And I do love gathering sharp-edged tools for my Bad-Ass armory.  I added quite a bit to the arsenal this week.